Lithium, medicinal use

Lithium, medicinal use of, 11 (1975) 193 Local anaesthetics, 3 (1963) 332 Lonidamine and related compounds, 21... 

Leprosy, chemotherapy, 20 (1983) 1 Ligand-receptor binding, 23 (1986) 41 Linear free energy, 10 (1974) 205 5-Lipoxygenase inhibitors and their antiinflammatory activities, 29 (1992) 1 Literature of medicinal chemistry, 6 (1969) 66 Lithium, medicinal use of, 11 (1975) 193 Local anaesthetics, 3 (1963) 332 Lonidamine and related compounds, 21 (1984)111... 

The importance of this history is that it meant there was a precedent for the use of lithium as a medicine. It also meant that lithium was readily available for experimentation in the pharmacies of psychiatric hospitals. Therefore when John Cade, an Australian psychiatrist, suggested that lithium might be a useful treatment in people with mania in the 1940s, it did not seem curious. Cade also experimented with use of the elements strontium and cerium in the treatment of psychiatric disorders, but they never caught on in the same way because there was no prior history of medicinal use. 

In regard to neuroleptics, we found that pioneers in their use were most straightforward about its brain-disabling effects. We find the same phenomenon with lithium. Cade (1949) indicated that lithium, when used for other medicinal purposes, produced actual mental depression in a variety of patients, not just those suffering from mania or manic depression. The drug enforced a so-called quieting effect on persons he considered schizophrenic (dementia praecox, in his nosology) ... 

The use of lithium in psychiatry has varied historically. In the nineteenth century, lithium salts were employed in the treatment of anxiety, as well as gout and seizures. The importance of lithium s antimanic actions was indirectly discovered, in 1949, with observations that it produced a calming effect in animals. Human testing in agitated or manic patients followed, with encouraging results. However, lithium s use did not gain acceptance in American medicine until 1970, due to safety concerns... 

Estrone, a key intermediate in the preparation of medicinally useful 19-norsteroids, can now be prepared in high yield at the remarkably low temperature of 35° from A -androstadiene-3,17-dione 17-ethyleneketal (1) by reaction with lithium-diphenyl in THF in the presence of a suitably acidic hydrocarbon such as diphenyl-methane to intercept the by-product methyllithium and prevent its addition to the potential 17-carbonyl group. ... 

Lithium has various medicinal uses, though at certain levels it can be toxic. In the nineteenth century, lithium was used as a treatment for gout, a painful condition where uric acid builds up around certain joints, particularly around the feet. As uric acid builds up, its molecules form crystals. These crystallized molecules are fairly insoluble, which can hamper treatment. However, doctors discovered that if lithium was incorporated into the uric acid compounds, the compound was more soluble, and thus easier to dissolve. Bathing in lithium-rich springs and spas soon became popular for treating gout. Unfortunately, it was discovered that the lithium was too diluted in these spa waters to have any beneficial effect. 

Lithium extraction takes place mainly in North and South America from rocks and brines associated with volcanic activity and aridity. Most of the world s lithium is used in the production of lightweight metal alloys, glass, lubrication greases, and electrical batteries. Only a small proportion of lithium production (less than 1% of the total) is used in medicine. 

A special lithium cell uses an iodine cathode with an in situ formed solid electrolyte which is very stable and used in implantable devices in medicine. These devices have been widely used in... 

Some elements found in body tissues have no apparent physiological role, but have not been shown to be toxic. Examples are mbidium, strontium, titanium, niobium, germanium, and lanthanum. Other elements are toxic when found in greater than trace amounts, and sometimes in trace amounts. These latter elements include arsenic, mercury, lead, cadmium, silver, zirconium, beryUium, and thallium. Numerous other elements are used in medicine in nonnutrient roles. These include lithium, bismuth, antimony, bromine, platinum, and gold (Eig. 1). The interactions of mineral nutrients with... 

Individual polyethers exhibit varying specificities for cations. Some polyethers have found appHcation as components in ion-selective electrodes for use in clinical medicine or in laboratory studies involving transport studies or measurement of transmembrane electrical potential (4). The methyl ester of monensin [28636-21 -7] i2ls been incorporated into a membrane sHde assembly used for the assay of semm sodium (see Biosensors) (5). Studies directed toward the design of a lithium selective electrode resulted in the synthesis of a derivative of monensin lactone that is highly specific for lithium (6). 

Lithium compounds are used in ceramics, lubricants, and medicine. Small daily doses of lithium carbonate are an effective treatment for bipolar (manic-depressive) disorder but scientists still do not fully understand why. Lithium soaps—the lithium salts of long-chain carboxylic acids—are used as thickeners in lubricating greases for high-temperature applications because they have higher melting points than more conventional sodium and potassium soaps. 

In addition to the use of chlorine as an antiseptic for swimming pools and drinking water, large amounts are used during industrial processes that produce paper, plastics, textiles, dyes, medicines, insecticides, solvents, and some paints. Following are some of the more important compounds of chlorine used in industries hydrochloric acid (HCl + H O), table salt (NaCl), chloroform (CHCL ), carbon tetrachloride (CCy, magnesium chloride (MgCl ), chlorine dioxide (CIO ), potassium chloride (KCl), and lithium chloride (LiCl). 

Lithium bromide is used in absorption, refrigeration and air-conditioning systems. A highly concentrated solution of the salt is an efficient absorbent of water vapor. The vapor pressure of such solution is very low. Other applications include the use of the salt as a swelling agent for wool, hair and other organic fibers as a catalyst in dehydrohalogenation reactions and as a sedative and hypnotic in medicine. 

Lithium carbonate is used in enamels, specialty glasses and special ceramic wares. It is used to produce glazes on ceramics and porcelains. It also is used as an additive to molten aluminum fluoride electrolyte in Hall-Heroult process. It is the starting material to prepare many other hthium salts. The compound also is used in medicine as an antidepressant. 

Lithium sulfate is used in making a special type of high strength glass. It also is used in medicine as an antidepressant. 

In the Expert Consensus survey (Rush and Frances, 2000), the respondents endorsed divalproex/valproic acid and carbamazepine as first-line medicines, followed by lithium and gabapentin (second-line interventions). Unfortunately, there are insufficient data on use of any of these—except, perhaps, on lithium—to draw any conclusions at this time. 

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